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COVER PAGE <br />Applicant Contact Information <br />Applicant Organization’s Legal Name:Pee Wee Homes <br />Applicant Organization’s Physical Address:8410 Merin Road, Chapel Hill, NC 27516 <br />Applicant Organization’s Mailing Address:PO Box 17102, Chapel Hill, NC 27516 <br />Applicant Organization’s Web Address:https://peeweehomes.org <br />Executive Director:Erika Walker <br />Telephone Number:(919) 590-9023 E-Mail:info@peeweehomes.org <br />Tax ID Number:82-2624086 <br />Funding Request <br />Please list all Fiscal Year 2024 Human Services (HS) funding requested for all programs and the proposed <br />use of funds (please list program name only) <br />Program Carrboro - HS Chapel Hill - HS Orange County-HS Total <br />Resident Support Program 3,000 12,500 14,000 29,500 <br />Totals 3,000 12,500 14,000 29,500 <br />Briefly explain your proposed use of funds: <br />To the best of my knowledge and belief all information and data in this application is true and <br />current. The document has been duly authorized by the governing board of the applicant. <br />Signature: <br />Executive Director Date <br />Signature: <br />Board Chairperson Date <br />Application Signatures: Please submit a wet signature or electronic signature,MS Word cursive fonts are not <br />acceptable. <br />Cover Page Page 7 of 24 <br />01/11/2023 <br />01/11/2023 <br />DocuSign Envelope ID: B7578AEA-ACB5-4FAD-8F8A-86A7F4B5A037